Goitre - Diagnosing goitre

If you think you have a goitre, see your GP. They can examine your neck to see if there's any evidence of thyroid gland swelling.

Blood tests to check how well your thyroid gland is working may also be carried out.

Physical examination

Your GP will examine your neck to assess the size and extent of any swelling and determine whether it's:

a diffuse goitre – where your entire thyroid gland swells up and feels smooth
a nodular goitre – where solid or fluid-filled nodules develop within the thyroid, making the thyroid gland feel lumpy

They may ask you to swallow, to see whether the lump moves up and down.

Your GP may also arrange for you to have a thyroid function test to determine the underlying cause of your goitre.

Thyroid function test

A thyroid function test measures the level of certain hormones (chemicals produced by the body) in your blood.

The test can show if you have an underactive or overactive thyroid gland, both of which are associated with goitre.

The thyroid gland produces two hormones – thyroxine and triiodothyronine. An excessive amount of these two hormones indicates an underlying condition that's making your thyroid gland overactive, such as Graves' disease (an autoimmune condition that causes antibodies to stimulate the thyroid gland).

If your thyroid gland is underactive, your pituitary gland (a pea-sized gland that sits below the brain) will produce a hormone called thyroid stimulating hormone (TSH).

TSH is released by your body to stimulate your thyroid gland. A high level of TSH in your blood indicates that your thyroid gland is underactive.

Further tests

If you're referred to a specialist, you may have further tests in hospital. These are described in more detail below.

Radioactive iodine scan

This involves a small amount of radioactive iodine being injected into your vein. The iodine builds up in your thyroid gland, which can then be studied using a special camera.

The scan can provide useful information about the structure and function of your thyroid gland. As the amount of radiation used is very small, it's perfectly safe for most people. However,it may not be suitable if you're pregnant.

Ultrasound scan

An ultrasound scan uses high-frequency sound waves to create an image of part of the inside of your body. It can be used to:

build up a picture of the inside of your thyroid gland
assess the size of your thyroid gland
check whether there are any enlarged nodules in your thyroid gland not found during the physical examination

Fine-needle aspiration

Fine-needle aspiration is a procedure where a sample of the goitre is extracted, so that the cells inside it can be tested. This procedure is often known as a biopsy.

During the procedure, a fine needle on the end of a syringe will be inserted into the goitre in your throat. A sample of the fluid or tissue inside the goitre will be sucked through the needle and into the syringe. The sample will be examined under a microscope to determine what kind of cells are inside the goitre.

Autoimmune condition: An autoimmune condition is when your immune system (the body’s defence system) produces antibodies (proteins) that should fight infections, but instead attack your body's healthy tissues.
Hormones: Hormones are groups of powerful chemicals produced by the body and have a wide range of effects.
Thyroid gland: The thyroid gland is found in the neck. It produces hormones that are released into the bloodstream to control the body's growth and metabolism (the process that turns food into energy).